A meta-analysis published online on January 19, 2007 in the British Medical Journal concluded that making positive lifestyle changes is at least as effective as using prescription drugs to prevent or delay the onset of type 2 diabetes.

Clare L. Gillies and colleagues at the University of Leicester in England analyzed data from 17 clinical trials which studied the effects of diet and exercise, diabetes drugs, and the anti-obesity drug orlistat on a total of 8,084 men and women with impaired glucose tolerance. When the effects of all forms of lifestyle interventions on the individuals who adopted them were pooled they were found to reduce the risk of developing diabetes by 49 percent compared to individuals who received standard advice only. Exercise alone or exercise combined with dietary improvements appeared to be more effective than diet alone. Oral antidiabetes drugs were also effective at preventing or delaying diabetes, although the risk reduction determined by the analysis was not as great as that found for lifestyle changes. The drug orlistat alone had a comparable effect with that of lifestyle interventions. Diet and exercise also had the advantage of being associated with fewer adverse effects than those caused by pharmaceutical drugs, such as gastrointestinal effects or reduced liver function.

The authors ask whether what is fundamentally a lifestyle issue should be treated with a lifelong course of medication, and note that the potential adverse effects of pharmacological interventions in diabetes type 2 need to be completely understood to be able to assess their benefits and risks. Even minor adverse effects become more significant if a medication is to be taken for life.

"In 2000 an estimated 171 million people in the world had diabetes, and the numbers are projected to double by 2030," they write. "Interventions to prevent type 2 diabetes will therefore have an important role in future health policies."

They left a big one out, get rid of refined sugar. the number one cause of diabetes. as for the lifestyle change, they already know this, getting people to do it is a differnt story. hopefully this will make the doctors push harder for the diet and exercise.